Providence VA leads national study of veterans' amputation needs

Brown University's Linda Resnik heads $2.5-million research of veterans who lost hands or arms in Iraq and Afghanistan

G. Wayne Miller Journal Staff Writer gwaynemiller

PROVIDENCE, R.I. – A national team led by Linda Resnik, a Brown University professor and research scientist at the Providence VA Medical Center, is leading a national study of the needs of veterans with traumatic upper-limb amputations -- the most common of which is loss below the elbow, typically suffered in combat.

Among other issues, the research will examine why only seven in 10 upper-limb amputee veterans who served in Afghanistan and Iraq were satisfied with their prostheses – compared to more than 90 percent of lower-limb amputees, according to a study by the U.S. Department of Veterans Affairs’ Office of Inspector General completed in 2011.

“We need data to better understand the needs of people with upper-limb amputations and to assess their limitations in functioning, their participation in life roles, and their satisfaction with prosthetic devices and the amputation rehabilitation care that they have received,” Resnik said.

The collected data, she said, will be used “to improve the quality of amputation care” for veterans and help healthcare professionals in the VA system with "prescriptions and rehabilitation services.”

Resnik and her Providence team are coordinating the three-year study with investigators from the Brooke Army Medical Center in San Antonio, Texas; and VA medical centers in Puget Sound, Wash.; Gainesville and Tampa, Fla; and Richmond, Va.

Dr. Joseph Webster, medical director of the VHA Amputation System of Care at the Hunter Holmes McGuire VA Medical Center in Richmond, Va., said the research is not focused on the development of advanced prosthetics but rather “getting a better understanding of exactly how people with upper-extremity amputations function both with and without prosthetic devices.”

Webster said: “This is a small component of the amputee population that's served in the VA, but it's a population that has somewhat unique needs and requires unique considerations. The outcomes for these Veterans, as far as their prosthetic use and satisfaction, are still limited.”

The study is made possible by the Defense Department’s Orthotics and Prosthetics Outcomes Research Program, which awarded a $2.5 million contract to the Ocean State Research Institute, the nonprofit arm of the Providence VA Medical Center.

According to the VA, among veterans “upper-limb amputation is much less common compared with lower-limb loss, although the percentage has risen in recent years due to the many soldiers who have lost hands and arms in roadside blasts while on patrol in Iraq and Afghanistan.”

In fiscal 2016, the department said, 22 percent -- 20,158 individuals -- of veterans “who received amputation care at VA facilities had experienced an upper-limb amputation. Of those, 16 percent -- 3,225 -- had a major upper-limb amputation, which is a procedure at the wrist level or higher on the arm.”

Resnik is the study’s principal investigator. In addition to her VA responsibilities, she is a professor with Brown University’s Department of Health Services, Policy and Practice.